315P - Molecular testing in lung squamous cell carcinoma using DNA- and RNA-based next-generation sequencing: A single-center experience

Background

The current NCCN Guidelines® (v3.2022) recommend for the first time broad molecular testing also in lung squamous cell carcinoma (SCC). However, data regarding real-world testing experience is exceedingly rare in this context.

Methods

In our center, we perform NGS (DNA- and RNA-based) analysis of all non-small cell lung carcinoma, regardless of stage, at the time of the first diagnosis. Here, we performed a retrospective study of all analyzed lung SCC patients who were tested between January 2020 to June 2022.

Results

We identified 147 SCC patients who were tested with DNA-based NGS (for mutation detection) and 159 patients who were tested with RNA-based NGS (for fusion detection). In 55/147 (37.4%) patients tested with DNA-based NGS we observed a mutation/amplification in a potentially targetable genes (22x PIK3CA, 13x FGFR, 7x DDR2, 5x EGFR, 3x KRAS^G12C, 2x AKT1, 2x BRAF, 1x MAP2K1). In 8/159 (5%) patients tested with RNA-based NGS, we detected a potentially targetable fusion/skipping mutation (3x ALK fusion, 2x EGFRfusion, 2x MET exon 14 skipping, 1x FGFR3 fusion).

Conclusions

Our real-world molecular pathology study demonstrated the importance of molecular profiling of SCC in the lung, in the same reflex manner as it is done for adenocarcinoma. It showed clearly the potential therapeutic value. In addition, NGS also improved the diagnostic accuracy, especially in cases with multiple primary tumors and/or metastases. Therefore, we argue for the implementation of reflex NGS testing in all non-small cell lung carcinomas, irrespective of histologic type.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.